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META-ANALYSIS OF EFFICACY OF BISPHOSPHONATES IN NON-TRAUMATIC OSTEONECROSIS OF FEMORAL HEAD

LIHUA CHEN, QIN HUANG *

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This study systematically evaluated the efficacy of bisphosphonates (BPs) in non-traumatic osteonecrosis of the femoral head (NTONFH) through meta-analysis. Controlled clinical trials published up to December 2023 were searched in PubMed, Embase, Cochrane Library, Web of Science, ScienceDirect and other databases. Study quality was assessed using the Cochrane risk of bias tool, and meta-analysis was performed with Review Manager 5.3. Seven studies involving 440 patients (511 hips) were included, with 227 patients (258 hips) receiving BPs. Compared with the non-BP group, BPs significantly reduced progression to collapse (OR = 0.41, 95% CI = 0.18 - 0.90, P = 0.03) and total hip arthroplasty rates (OR = 0.44, 95% CI = 0.20 - 0.96, P = 0.04). They also improved Harris hip scores (MD = 7.34, 95% CI = 0.06 - 14.62, P = 0.05) and SF-36 scores (MD = 2.39, 95% CI = 0.24 - 4.54, P = 0.03). No significant difference was found for Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) scores between groups.